Burnout in Danish General Practice development, risk and prognosis

Transcription

1 Burnout in Danish General Practice development, risk and prognosis Christina Maar Andersen, Cand.psych. Research Unit for General Practice Aarhus University Bartholins Allé Aarhus C Tel.: (0045) [email protected] Financial support The Quality and Continuing Education Council for General Practice in the Central Denmark Region and the Committee of Multipractice Studies in General Practice.

2 Background Burnout among physicians is a growing problem. Burnout among physicians has implications for both the physicians and their patients. Mulligan K. Self care for general practitioners. Aust Fam Physician 1997 Jul;26(7): European Forum of Medical Associations and WHO. Statement on the burnout-syndrome among physicians. Berlin: EFMA; Wallace JE, Lemaire JB, Ghali WA. Physician wellness: a missing quality indicator. Lancet 2009 Nov 14;374(9702):

3 Agenda Current status of burnout among general practitioners. The development of burnout within the last 7 years. Age and gender differences in burnout. Risk factors associated with the development of burnout. Prognosis.

4 Burnout Emotional exhaustion Depersonalisation Moderate burnout: emotional exhaustion and/or depersonalisation Personal accomplishment Severe burnout: emotional exhaustion depersonalisation and personal accomplishment Maslach C, Jackson S. The measurement of experienced burn-out. Journal of Occupational Behavior 1981;2:

5 Methode In 2004, all GPs in Aarhus county (N = 458) were invited to participate in a study on burnout follow-up among all GPs in Central Denmark Region (N = 835).

6 Development of burnout 2004: GPs in Aarhus county (N = 379) 2012: all GPs (N = 601) 2012: GPs in Aarhus county (N = 363) N n % 95% CI N n % 95% CI N n % 95% CI High degree of emotional exhaustion High degree of depersonalisation Low degree of personal accomplishment ** ** * ** Moderate burnout Severe burnout Pedersen, A. F.; Olesen, F.; Andersen, C. M.; Vedsted, P Arbejdsbelastning blandt alment praktiserende læger: En undersøgelse i Region Midtjylland. Rapport, 1 ed. Aarhus: Research Unit for General Practice, s.

7 Age differences 2012 Youngest age group (<45 years old) N=128 Middle age group (45-54 years old) N=199 Elder age group ( 55 years old) N=254 High degree of emotional exhaustion N n % N n % N n % P- value 19.8 ( ) ( ) ( ) High degree of depersonalisation ( ) ( ) ( ) Low degree of personal accomplishment ( ) ( ) ( ) Moderate burnout ( ) ( ) ( ) Severe burnout ( ) ( ) ( ) Pedersen, A. F.; Olesen, F.; Andersen, C. M.; Vedsted, P Arbejdsbelastning blandt alment praktiserende læger: En undersøgelse i Region Midtjylland. Rapport, 1 ed. Aarhus: Research Unit for General Practice, s.

8 Gender differences 2012 Female GPs (N=284) Male GPs (N=312) N n % 95% CI N n % 95% CI P-value Moderate burnout Severe burnout Pedersen, A. F.; Olesen, F.; Andersen, C. M.; Vedsted, P Arbejdsbelastning blandt alment praktiserende læger: En undersøgelse i Region Midtjylland. Rapport, 1 ed. Aarhus: Research Unit for General Practice, s.

9 Age differences Female GPs Youngest age group (<45 years old) N=72 N n % Moderate burnout Severe burnout ( ) 5.8 ( ) Male GPs Youngest age group (<45 years old) N=128 N n % Moderate burnout Severe burnout ( ) 10.9 ( )) Pedersen, A. F.; Olesen, F.; Andersen, C. M.; Vedsted, P Arbejdsbelastning blandt alment praktiserende læger: En undersøgelse i Region Midtjylland. Rapport, 1 ed. Aarhus: Research Unit for General Practice, s.

10 Risk of developing burnout 2004 Not burned-out Burned-out Not burned-out Burned-out The risk of developing burnout was 13.2% (95%CI: ) Pedersen A.P.; Andersen, C. M.; Olesen, F; Vedsted, P. Risk of burnout in Danish GPs and exploration of factors associated with development of burnout: a two-wave panel study. International Journal of Family Medicine. (in press).

11 Predictors GPs who in 2004 did not answered yes to the question: Would family medicine still be your choice if you were to select your medical specialty today? had a 4.5 times increased risk of developing burnout in 2012 (OR=4.5; 95% CI: ; p=0.023). Pedersen A.P.; Andersen, C. M.; Olesen, F; Vedsted, P. Risk of burnout in Danish GPs and exploration of factors associated with development of burnout: a two-wave panel study. International Journal of Family Medicine. (in press).

12 Prognosis withdrawel from general practice 26.1% of GPs who were burned-out in 2004 withdrew from practice compared to 31.0% of GPs who were not burned-out (adj. OR = 0.97; 95%CI: ; p = 0.935) Pedersen A.P.; Andersen, C. M.; Olesen, F; Vedsted, P. Risk of burnout in Danish GPs and exploration of factors associated with development of burnout: a two-wave panel study. International Journal of Family Medicine. (in press).

13 Conclusion The degree of severe burnout has increased considerably since The risk of developing burnout was 13%. Not wanting to choose general practice again as a specialty" increased the risk of developing burnout by 4.5 time. Burned-out GPs appear not to have higher job turnover rates than GPs who are not burned-out.